Friday, November 2, 2007

Ok, so its a long time since I cribbed...not that i've had nothing to crib about, but i've just been lazy. Something that I was browsing through today made me post this.

For the first time, I looked up reviews of hospitals in Bangalore, and I was pretty shocked to read that nobody had anything nice to say about their experiences there. Most of the complaints seem to be about hospitals in the corporate sector. I observed a few common complaints..

1) Misdiagnosis2) Surgery recommended in the hospital when it wasn't required3) High costs4) Doctor not listening to the patient's problems5) Unnecessary tests

While no doctor likes to be wrong in his diagnosis, mistakes do occur and the serious ones tend to be fatal on rare occasions. One must understand that medicine is a vast science and is constantly evolving. While other professions allow for mistakes to be easily rectified without much loss to life or property, it is hard to expect that sort of cushion in medicine. There are a huge number of probabilities in everything we do. I cant even think of listing them here. A patient who comes with fever could probably be just suffering from a minor throat infection that would go away in a couple of days, or he may be suffering from something as serious as dengue fever that may kill him in the next few days if untreated. That is why even simple symptoms are sometimes subjected to a battery of tests which may not make sense to someone out of the medical field. They are quick to blame the doctor for unnecessary tests if it is a simple problem and are quick to sue the doctor if it turns out to be something serious.

There is however no excuse for negligence by a doctor. Negligence does occur, but is rarely seen in larger hospitals. Most of the cases of negligence I have seen occur in government run setups and small nursing homes. These places do not have doctors with the required expertise, equipment and backup to handle problems and are usually the source of mismanaged patients.

High costs by corporate hospitals are mainly due to the money invested in infrastructure and equipment. To put it in perspective, to furnish a single ICU bed with basic equipment (ventilators, monitors, etc) would cost the hospital a minimum of 10 lakhs. The maximum price for ICU rental per day in Bangalore would be about Rs 5000. Nobody seems to complain when they pay 3 times that price for a hotel room in this city which would have cost the hotel far less to furnish!

Doctor not listening? Doctors usually listen to a point till they have sufficient information to make a diagnosis. Sometimes, the clinical picture is good enough to make a diagnosis. Many times the patient or his relative provides facts that are irrelevant.

Like any other field, nobody in the medical profession wants to be bad. We all work very hard to provide medical care to the best of our ability. Most of the patients we see improve and go home happy. Some people are so distraught about the thought of losing a loved one, that they fail to accept that some conditions (like cancer) cannot be cured. In their ability to accept reality, such individuals are quick to blame medical care as the cause of a patient's death, but not the disease itself. Some reassure themselves that the patient would be ok in a day, when the truth is, he would be dead in a day. In short, people sometimes expect miracles. Miracles in medicine do occur, but not to everyone and not every day.

I'm not making excuses for doctors in this post. Amidst the thousands who do a great job, there are a few who are Grade 'A' scoundrels. However, good hospitals tend to filter out these weeds.

How do you get good medical care in Bangalore? I would suggest you follow some stuff that I have mentioned below.

* Get a health insurance policy. It will help you cover large hospital bills.

* Avoid small nursing homes for surgical procedures and deliveries. Most of these places are not well equipped. Many choose them to cut costs. Its not worth it. They are ok for a medical consultation... but not for surgeries.

* Larger hospitals have better trained doctors & staff. They also have better backup facilities if an emergency arises.

* If you are unhappy with the care you are getting at a hospital, approach the management with your problem. Hospitals such as the one I work in take complaints like this seriously and we deal with it efficiently. If the hospital management is not willing to discuss the problem (if it is legitimate) with you, then you would be justified in moving to another hospital.

* If in doubt, you are free to get a second opinion. However, keep in mind that even if the second opinion sounds better than the first, it has an equal possibility of being wrong.

* If possible, have a doctor as a friend. He may be able to guide you when you need some help.

* Do not tell the doctor how he must treat the patient and what medications he should get. Not only does this thoroughly annoy the doctor, it makes you look like a complete idiot.

Saturday, March 31, 2007

There’s a reason why Indians confuse everyone. Were loud, brash, sometimes mannerless, very uncouth and do as we feel in public. This does not go down well with other populations. Were also smart, well educated, extremely capable, proud and highly emotional. The Indian personality is filled with myriad traits, just as some of the recipes from our land.

Pride is very important for us. Whatever we do, we seem to be proud of it. It may not be apparent, but if you put an Indian tea vendor and Bill Gates in a room, you can be sure that the tea vendor will argue about how much important and better his job is.

We look for reasons to be proud. Apart from our personal achievements, we look for reasons to be proud of our country. Our heritage of the past has been shattered by the way religion, politics and human rights have been abused in this country. So your average Indian looks in every corner to find something to be proud of, and when he finds something worthy, he places it on the highest pedestal.

Over the last 2 decades, most Indians look at the Indian cricket team to find something to be proud of. The problem with us is that the moment a sports person does something slightly extraordinary, we are quick to elevate them to the highest pedestal. Once on the highest pedestal, these people, with the help of the media (another abused institution in this country) are glorified beyond anyone’s wildest dream.

We look for pride in cricket because its quick to achieve, it involves beating another country and its relatively non violent (unless you’re a Pakistani coach). Its only obvious that the national pastime in finding pride is to back your cricket team. No surprises that they are worshipped and revered.

Indians like to achieve and win. Some of us are aggressive, ruthless and fiercely competitive about it. So competitive that kids who get 90%+ marks in examinations these days fail to get the field of their choice, because a zillion other kids got more than 95%. Corporate houses are buying each other out in India and abroad, making statements about who we are. Were trying hard to send someone or something to the moon next year. Somewhere around the place, some Indian is doing something real hard, to be recognized, so that he can be proud of what he has achieved.

Now if you are among the 15 people selected to make your country really proud, how would you feel? A bit nervous maybe.. but you’ve been carrying that responsibility for the last few years. Whatever the negative feelings are, deep inside, you would think that if you had to, you would give your life to make your country proud.. or atleast put in an equal effort.

Yes, they lost to a Bangladeshi team full of school kids. They couldn’t make 250 after pompously making 400+ a few days earlier against a team of jelly bellies. The great cricket gurus within the team say “it happens”.

It shouldn’t

It shouldn’t happen if you play with some effort. It shouldn’t happen if all that you’ve done in your life is play cricket and aimed to get better everyday. It shouldn’t happen if you spent your free time trying to get better at your game rather than trying to sell a cola or a biscuit on TV. It shouldn’t happen if you’re proud that you have been given the opportunity to make a billion proud. It shouldn’t happen if you played for the pride of a billion.

It’s all our fault, we made heroes of people who didn’t deserve to be. Indian cricket has gotten much like the World Wrestling Federation. A total sham. The purity of cricket has gone with the way the game is being sold.

In the end, I’m a bit happy that they are coming back. It gives us a chance to watch some really good cricket, played by people who play the game with the heart and soul that it deserves.

Sunday, December 31, 2006

When I was about 8 years old (everything I post about here seems to have happened when I was 8!), my brother handed me a cricket bat and we headed to my backyard. Of the first few balls I faced, I remember tonking one real hard and it got stuck above one of the doors. I think I enjoyed that a bit. These were my first moments with the game of cricket.

I remember the summer holidays when I was 15. The whole neighbourhood would gather every afternoon in my backyard and we would have sessions of 'short cricket'. It was something everyone would look forward to, and those images and times never seem to fade from my mind.

Then there was always "Victory Grounds", a playground near home where most of the local community would gather for sports. Cricket being the most dominant, though some of the louts there engage themselves in a bit of soccer too. I used to frequent this ground often, but somehow broke away when I joined med school.

If I can recollect the year correctly, it was probably 1999, when another cricket crazy friend and I decided to just fool around with the bat and the ball. It would be just the two of us... bowling at batting in turns. As the weeks went by, we were joined by others who had a similar passion for the game. The group that started out as 2, eventually numbered a lot more. (Probably 15 was the highest).

We were joined by people from different backgrounds and different ages. Some were students, some worked. We just knew each other's first names. Nothing much was discussed, and nobody was really interested in getting to know each other very well. Everyone turned up at the ground on saturdays and sundays, and the game was played with a lot of passion.

This passion went on for years. We managed to forge ourselves a team and spent our weekends playing in the dust bowl and sometimes going to far off grounds to play against other teams. The pinnacle being our rivalry with another 'resident' team at Victory Grounds.. who I shall just call .. "The evil H-Colony gang" :o)

What was quite remarkable was, though I spent a good deal of time with these guys, I don't think I knew anyone's last name. I really didn't know exactly what each of them did. I absolutely didn't know where any of them lived! Not exactly the ingredients for a great friendship. Strangely, these basic things did not stop us from having the time of our lives on the field. We all had one thing in common..love for the game, and it bonded us stronger than some other friendships that I have endured.

This team disbanded in 2004 when I had to give up the time for my studies, Most of the guys moved onto other things, but in November 2006, we reunited and are limping our way back to our "days in the sun". The core members of this team remain. The evil H-Colony gang is still there too! (We'll beat em!).

In the years that we disbanded, I realized how a strong passion can create a lasting bond. I know that given a choice, we would do nothing else but put on our dusty shoes and head to Victory Ground. We could ape our heroes, we could release our frustrations and we could leave the world behind when we played over there. It didn't matter if we scraped a knee, crashed into each other or got rapped on the nuts there... it was fun, and will always be.

Sunday, December 3, 2006

Its twilight time for my post graduation. If all things go as planned, these are the last 2 - 2.5 months that I would have to work as a post graduate (also known as resident/scut etc).

I did some rough calculations. To earn a masters degree in anesthesiology at the hospital I work at, a resident has to put in about 14000 hours of work in 3 years. That is something like 4500+ hours of work a year. This excludes time spent studying. An average worker in the USA spends about 2000 hours a year working.

The last 3 years have had a huge influence on my personality. I've always considered myself as a mild individual and never expected anesthesiology would be my calling. Since it was the only speciality I could get into, I took it, not really knowing what to expect.

Somehow, humans have this remarkable ability to adapt to the worst of situations. That is how we somehow pick up our lives even after the worst tragedies hit us.. like the loss of a loved one, dealing with disability, or having to put up with a spouse's cooking.

I'm not saying that post graduation in anesthesia was a tragedy...i'm saying it was bloody hard. Perhaps one of the hardest things one can do. Long hours, extreme stress, some crazy colleagues and even crazier superiors.I have worked 32 hours straight without sleep, I have had to deal with the wrath of angry inconsiderate relatives of patients, I have had to tell countless people that their relative (father/mother/brother/sister/son/daughter) just died, I've yelled my guts out at lazy nurses, had to watch in horror while doctors make the wrong medical decisions, and had to deal with some ridiculously stupid surgeons. I've even been sued for someone else's mistake !

But most of all, I realized that nobody really knows what an anesthesiologist does. Its bad enough that patients really dont know what we do, but its terrible that people within the medical profession also fail to understand what we do.

Who is the anesthesiologist?

I could write a book on what we do. Maybe i'll write a blog on what we do. But if I had to put it in a nutshell...

An anesthesiologist is someone who guards life, and will fight hard to see that someone in his care stays alive no matter how bad the situation is.

Its like this... when God decides to shift someone to heaven or hell...they wind up at the hospital in transit (hospitals are like small airports), and when an anesthesiologist steps in the room, God would slap his head and says... "Who let that guy in?"

Despite the the crap i've taken over the last two and a half years, I've realized that I serve in the most dedicated field of medicine there is. Nobody may appreciate everything... if not anything we do... but in the end..

Sunday, November 26, 2006

Of all the things wrong in the world today, you also have to deal with watching the indian team going through its worst patch ever. Not only is the team playing bad, the team composition is outrageous.

Though hailed as a game of "glorious uncertainties", an indian loss seems certain on the day of a game.

A population of 1 billion cant churn out 15 world class cricketers? That too in a nation that has been cricket crazy for several generations now! On paper, we have a team full of stars. Each man capable of winning a match on his own. Put them all together and they appear like (fat) blue bunnies.

I'm a great admirer of Rahul Dravid, he lives down the road from me and what he has achieved over the years is nothing short of remarkable. But when he says that india needs harder pitches, he also needs a kick up the back side.

Yes, India needs better pitches. What it needs more than that is for Mr. Dravid and company to play on them. When was the last time Dravid played for his state team? When was the last time anyone who became a hotshot in the indian team played for their state team? The problem is that cricketers assume that once they make it to the big league, they are too big for domestic cricket.

You have Irfan Pathan who has forgotten if he is a bowler or a batsman. His amnesia now has persisted for months. The brains trust thinks he could be fixed in the nets. Nets?

The nets are the cosiest places for cricketers. Why? Because you have the same bowlers bowling at you over and over again. There is no shame if you get out, and there is no pressure. Nobody knows if that cover drive you just creamed went between 2 fielders or into one's hands.

As poor as our domestic cricket scene is, no national cricketer deserves to be above it. I am sick of seeing and hearing about how 'rusty' the players are at the start of a season and throughout it. Do you see a rusty australian team? The trouble with cricket is that no matter how good you are, a 'break' from your speciality, even for a short period gets you out of the groove. I'm sure the substandard domestic cricket bowlers would be a rejuvenated lot if they were bowling to players from the national side...not to mention cock-a-hoop when they get them out.

With our pathetic bench strength, I cant imagine what kind of a team we would have in another 2-3 years when possibly the likes of Sachin, Rahul, Kumble, Laxman would be heading for retirement. If Raina, Jaffer et al. are our future, god save us.

Bringing back Saurav Ganguly and Laxman is probably the need of the hour. Gautam Gambhir is a much better standby opener than Wasim Jaffer. The only indian bowler who looks good for a scrap, Sreesanth has been carrying drinks. Pathan needs to go back to domestic cricket and re-educate himself, just the way Zaheer Khan did by playing county cricket. Kaif will not last another season if he plays this way, and he, along with Sehwag should be playing in the Ranji teams.

Not a single player in this side looks good for a fight. The legacy of the indian tiger seems to have disappeared with Saurav Ganguly's exit. India will never have a finer captain than him. Not because he was an outstanding batsman (prior to captaincy), nor was he the greatest mind on the field, but because he somehow turned a bunch of pussycats into tigers. To inspire your team members to perform extraordinary feats without actually leading from the front is pure genius.

Speaking of geniuses...I fail to understand why our current coach believes so much that playing kho-kho (ouch Yuvraj Singh), football, rugby & volleyball will turn the team into better cricketers. I haven't seen any other sports team play cricket.....perhaps I never will. "Dog and the bone" next?